NPfIT – criminal incompetence says The Times

In an editorial not everyone would have seen, The Times said the history of the NPfIT was “one of criminal incompetence and irresponsibility”.

The main leader in The Times on 23 September had the headline “Connecting to Nowhere”.

It said:

“The comically misnamed Connecting for Health will continue to honour its contracts with big companies and to swallow taxpayers’ money for some time to come: up to £11bn on current estimates. The figure demonstrates the truly egregious scale of the previous Government’s incompetence on this issue: this vast sum seems to have been committed irrevocably, even though the project has never achieved its objectives.

“The story is a dismal catalogue of naivity, ambition and spinelessness. NHS managers and officials …were [not] brave enough to question the direction of travel at crucial moments when IBM and Lockheed pulled out of the project early on. Whitehall was sold a grand vision by consultants, software and technology companies charging grandiose fees. It signed contracts that appear to have been impossible to break when the promised land did not appear. Yet no one seems responsible. No one has been sacked. Most of the officials involved have long moved on…

“There have been spectacular failures in the private sector too. But businesses, with tighter controls on spending, tend to halt things earlier if they are going wrong. Many prefer off-the-shelf systems such as SAP or Oracle, which are tried and tested. They know that it is cheaper to adapt their processes, not the software.

“This newspaper is in favour of serious investment in technology, which could play an important part in economic growth. The NHS debacle has done enormous damage to this country’s reputation for expertise in IT systems. The lessons for the future are clear. Governments must hire people who can make informed and responsible procurement decisions. Patients, in every way, are going to end up paying the price.”

A separate article in The Times 0f 23 September included comments by Campaign4Change whose spokesman said that if the Department of Health continues to spend money on NPfIT suppliers it will probably get poor value for money.

Comment:

Compare the remarks in The Times with those of David Nicholson, Chief Executive of the NHS and Senior Responsible Owner of the NPfIT who refused to agree to a request by 23 academics to have an independent review of the scheme. Nicholson could not contain his enthusiasm for the NPfIT when he told the Public Accounts Committee on 23 May 2011:

“We spent about 20% of that resource [the £11.4bn projected total spend on the NPfIT] on the acute sector. The other 80% is providing services that literally mean life and death to patients today, and have done for the last period.

“So the Spine, and all those things, provides really, really important services for our patients. If you are going to talk about the totality of the [NPfIT] system … you have to accept that 80% of that programme has been delivered.”

It’s difficult to accept Nicholson’s figures. But even if we do, we’d have to say that the 20% that hasn’t been delivered was the main reason for the NPfIT: a national electronic health record which hasn’t materialised and isn’t likely to in the near future.

The contrasting comments of The Times and Nicholson’s are a reminder that the civil service hierarchy at the Department of Health operates in a world of its own, unanswerable to anyone, not even the Cabinet Office or Downing Street.

Can the Department of Health be trusted to oversee health informatics when it has such close relationships with major IT companies and consultants? While Katie Davis is in charge of health informatics there is at least an independent voice at the DH. But as an interim head of IT how long will she last? The DH has a history of not being keen on independent voices.

Correct me if I am wrong, but I believe that the marvellous Times leader Tony quotes is a rarity, or even a first.

A rarity in the sense that the big nationals don’t usually report Whitehall successes or failures on their news pages or comment on them in their op-ed columns. Ditto the broadcasters.

Which is a bit strange, if you think about it. Because look at what they do cover.

Think of political coverage. In the UK and abroad. Think of the coverage of armed conflict. What don’t we know about the celebrities covered in the entertainments pages? Or the sportsmen, their managers and their agents? And when it comes to business coverage, we know the companies, the directors, the rumours, the financial viability, the proposed plans, …

And yet when it comes to Whitehall, spending £400 billion+ of our money every year, who’s ever heard of Sir David Nicholson? Or CSC? Or Ian Watmore? Or Sarah Rapson? Answer, the few of us who follow Tony’s dedicated coverage. Fine. But what about the millions who read the Mail and the Telegraph and the Times and the Guardian and the Sun? Or who watch Newsnight or listen to Today?

We all know a staggering amount about the disputed merits of quantitative easing or selling the olympic stadium to Spurs. But NPfIT? Or “digital by default”? Or the Civil Registration Act on the horizon? Nothing.

Was Steve Jobs a great business leader? Everyone’s got an opinion. How about Sir Gus O’Donnell, head of the home civil service, the man with a budget over £400 billion? Who?

Let’s hope for many more leaders and articles like the ones Tony mentions. There’s a rich seam of news interest there which it remains baffling why the media don’t mine it.

Whitehall needs coverage. Openness would improve performance. And the public, too. We want, need, deserve and pay for a top quality Whitehall.